Ischemic Cerebrovascular Disease, commonly referred to as stroke, brain attack or cerebrovascular accident, can have a devastating impact on the victim and the victim's family. American Heart Association statistics indicate that there are approximately 500,000 cases of stroke each year and strokes are the leading cause of serious, long-term disability. The likelihood of experiencing a stroke increases with age with approximately 80% of all strokes are suffered by those over the age of 65. Thus, as the average age of American society increases, the number of people at risk for stroke will continue to increase.
In layman's terms, a stroke occurs when a cerebral artery in the brain becomes blocked or ruptures preventing the transport of oxygen and nutrients to the associated portion of the brain. If the brain cells are deprived of oxygen for more than a few minutes they die. With the death of the brain cells, the body function controlled by that portion of the brain is typically lost or at least seriously impaired.
One common method of assessing the impact of stroke on the victim is the Modified Rankin Scale. The Modified Rankin Scale has seven levels of impact ranging from a 0=no symptoms to 6=death. In between the two extremes, lie the following classifications:                1=no significant disability despite symptoms: able to carry out all usual duties and activities        2=slight disability: unable to carry out all previous activities, but able to look after own affairs without assistance        3=moderate disability: requiring some help, but able to walk without assistance        4=moderate to severe disability: unable to walk without assistance, and unable to attend to own bodily needs without assistance        5=severe disability: bedridden, incontinent, and requiring constant nursing care and attention.        
The methods of the current invention are primarily directed to improving the overall function and quality of life in stroke victims with Rankin scores of 2 (slight disability) to 4 (moderate to severe disability).
Several factors impact the patient's recovery from a stroke. In addition to the location and extent of the stroke, the patient's age and overall state of health impact the degree of recovery. The Merck Manual in Chapter 152, Section 14 notes that complete recovery from stroke is uncommon with those patients experiencing early improvements during treatment having a generally better overall prognosis. Typically, 50% of the patients with moderate to severe hemiplegia or milder deficits will recover functionally prior to discharge from the hospital. These individuals may eventually recover sufficiently to care for their own basic needs. Unfortunately, the Merck Manual states, “any deficit remaining after 6 mo is likely to be permanent, although some patients continue to improve slowly.”
Research directed toward stroke prevention and treatment of stroke is ongoing; however, progress is slow. In particular, virtually no research is focused on improving the quality of life for stroke victims after the initial rehabilitation process. Rather, a stroke victim with moderate to severe disability more than six months after the occurrence of the stroke is generally regarded as being permanently disability. Clearly, the lack of research directed to improving the quality of life for stroke survivors subsequent to the initial rehabilitation process is a result of the generally accepted view that improvement will not occur in such patients.
The generally accepted view notwithstanding, the current invention provides methods for rehabilitating stroke victims who are well beyond the generally accepted six-month treatment period. The rehabilitation methods of the current invention provide significant improvement in mobility, strength and range of motion to those body parts impacted by cerebrovascular disease. Accordingly, the current invention provides improved methods for treating victims of stroke and in particular for treating victims who continue to suffer disability more than six months following the occurrence of the stroke. The methods of the current invention are described in detail below.